Heparin

Question 1

LMWH;

Given ? (route), e.g. enoxaparin, ? acting.
Works to inactivate factor ? (but not thrombin).
? laboratory monitoring is usually required, if required (e.g. severe ? impairment) then anti-factor ? levels are used.
Can accumulate in ? failure, so a lower dose is used prophylactically, and ? used therapeutically.

Answer 1

sc
long
Xa
no
renal
Xa
renal
UFH

Question 2

UFH;

Given ? or ?, ? acting.
o Used if high risk of ?: anticoagulation can be ? rapidly.
o Also useful in severe ? where LMWH is contra-indicated.

Answer 2

iv
sc
bleeding
terminated
CKD

Question 3

UFH

Potentiates anti-? ?
o Increasing its ability to inhibit ?, factor Xa and IXa.
? is used to monitor therapy and adjust dosage.
—o Should be checked at ? hours, aiming for an ? of ?-?.

Answer 3

thrombin 3
thrombin
APTT
6
aptt
1.5-2.5

Question 4

Side Effects

Common to both LMWH and UFH, but less common in ?·
o Bleeding: e.g. ?, ? site, ?.
o Heparin-induced ?: HIT.
o ? with long-term use.
o ?.

Answer 4

LMWH
GI 
operative
intracranial
thrombocytopenia
osteoporosis
hyperK

Question 5

Contraindications;

? disorders, platelets previous ???, ? ? disease

Answer 5

bleeding
60
HIT
pud

Question 6

If over anticoagulated / bleeding;

UFH - ? infusion
Both - Give ? sulphate to counteract effects·
o Only partially effective in ?.

Answer 6

stop
protamine
LMWH

Question 7

Antidote = ?

Answer 7

protamine